SERUM CYSTATIN-C MEASURED BY AUTOMATED IMMUNOASSAY - A MORE SENSITIVE MARKER OF CHANGES IN GFR THAN SERUM CREATININE

被引:540
作者
NEWMAN, DJ
THAKKAR, H
EDWARDS, RG
WILKIE, M
WHITE, T
GRUBB, AO
PRICE, CP
机构
[1] UNIV LONDON LONDON HOSP,COLL MED,DEPT NEPHROL,LONDON E1 2AD,ENGLAND
[2] LUND UNIV,DEPT CLIN CHEM,LUND,SWEDEN
[3] LUND UNIV,DEPT CLIN PHYSIOL,LUND,SWEDEN
关键词
D O I
10.1038/ki.1995.40
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Serum cystatin C has been suggested as a new marker of GFR. For the introduction of this marker into clinical use a rapid and automated method is required. We have developed and validated an assay for serum cystatin C using latex particle-enhanced immunoturbidimetry. Intra- and inter-assay precision were < 3% and < 5% across the assay range. Analytical recovery was 93 +/- 3.8% and no lack of parallelism was demonstrated. Regression analysis of a method comparison with an enzyme-enhanced radial-immunodiffusion method, gave PETIA = 0.074 + 0.93 x SRID, r = 0.98, N = 100. Inter-assay precision profiles showed cystatin C was measured with two-fold better precision than creatinine on the same analyzer. Cystatin C measurement was neither interfered with by icterus nor by hemolysis. 1/cystatin C versus 1/creatinine concentrations gave r = 0.67, N = 469. Comparison of Cr EDTA GFR with 1/cystatin C and 1/creatinine gave r = 0.81 and 0.50, respectively, N = 206. Calculating diagnostic sensitivity for abnormal GFR showed cystatin C to be significantly (P < 0.05) more sensitive than creatinine (71.4 vs. 52.4%). Cystatin C measurement using PETIA technology can be automated on the same instruments used routinely for the measurement of creatinine and offers better analytical performance and probably improved clinical sensitivity as a screening test for early renal damage.
引用
收藏
页码:312 / 318
页数:7
相关论文
共 24 条
[1]   EFFICIENT PRODUCTION OF NATIVE, BIOLOGICALLY-ACTIVE HUMAN CYSTATIN-C BY ESCHERICHIA-COLI [J].
ABRAHAMSON, M ;
DALBOGE, H ;
OLAFSSON, I ;
CARLSEN, S ;
GRUBB, A .
FEBS LETTERS, 1988, 236 (01) :14-18
[2]   STRUCTURE AND EXPRESSION OF THE HUMAN CYSTATIN-C GENE [J].
ABRAHAMSON, M ;
OLAFSSON, I ;
PALSDOTTIR, A ;
ULVSBACK, M ;
LUNDWALL, A ;
JENSSON, O ;
GRUBB, A .
BIOCHEMICAL JOURNAL, 1990, 268 (02) :287-294
[3]   RELATIVE SENSITIVITY OF SERUM AND URINARY RETINOL BINDING-PROTEIN AND ALPHA-1 MICROGLOBULIN IN THE ASSESSMENT OF RENAL-FUNCTION [J].
AYATSE, JOI ;
KWAN, JTC .
ANNALS OF CLINICAL BIOCHEMISTRY, 1991, 28 :514-516
[4]   THE PLACE OF HUMAN GAMMA-TRACE (CYSTATIN-C) AMONGST THE CYSTEINE PROTEINASE-INHIBITORS [J].
BARRETT, AJ ;
DAVIES, ME ;
GRUBB, A .
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, 1984, 120 (02) :631-636
[5]   NOMENCLATURE AND CLASSIFICATION OF THE PROTEINS HOMOLOGOUS WITH THE CYSTEINE-PROTEINASE INHIBITOR CHICKEN CYSTATIN [J].
BARRETT, AJ ;
FRITZ, H ;
GRUBB, A ;
ISEMURA, S ;
JARVINEN, M ;
KATUNUMA, N ;
MACHLEIDT, W ;
MULLERESTERL, W ;
SASAKI, M ;
TURK, V .
BIOCHEMICAL JOURNAL, 1986, 236 (01) :312-312
[6]  
BRAUNER L, 1981, CLIN PHYSIOL, V1, P175, DOI 10.1111/j.1475-097X.1981.tb00885.x
[7]  
BROCHNERMORTENS.J, 1982, SCAND J CLIN LAB INV, V30, P271
[8]   CYSTATIN-C LEVELS IN SERA OF PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION - A NEW AVIDIN-BIOTIN ELISA ASSAY FOR ITS MEASUREMENT [J].
COLLE, A ;
TAVERA, C ;
PREVOT, D ;
LEUNGTACK, J ;
THOMAS, Y ;
MANUEL, Y ;
BENVENISTE, J ;
LEIBOWITCH, J .
JOURNAL OF IMMUNOASSAY, 1992, 13 (01) :47-60
[9]  
Deming W. E., 1943, STAT ADJUSTMENT DATA, P184
[10]  
Galen R. S., 1975, NORMALITY PREDICTIVE